Skripsi

Telaah Persalinan Ibu Dengan Diabetes Di Kota Depok Pada Era Sebelum Pandemi dan Era Pandemi COVID-19 = Study on The Association between Mode of Delivery and Diabetes in Pregnancy in Kota Depok before and during COVID-19 Pandemic Era.

Latar belakang: Ibu hamil dengan diabetes memiliki kemungkinan lebih tinggi mengalami persalinan secara sesar dibandingkan persalinan normal serta kemungkinan lebih tinggi memiliki luaran bayi macrosomia. Adapun tindakan keadaan kehamilan dengan diabetes, tindakan sesar dan luaran bayi macrosomia ini memiliki dampak buruk bagi kesehatan dan keselamatan ibu dan bayi. Pandemi COVID-19 yang terjadi dari tahun 2020 di Indonesia, memengaruhi beberapa aspek dalam kehidupan, salah satunya adalah aspek kesehatan. Salah satu penyakit yang meningkat kejadian dan keparahannya pada pandemi diantaranya adalah diabetes. Hal tesebut tentunya menjadi hal penting yang perlu diperhatikan terutama oleh para ibu, agar tidak mengganggu kesehatan ibu dan calon bayi yang lahir nantinya. Metode: Penelitian dilakukan dengan desain cross-sectional analitik, dengan data sekunder berupa rekam medis ibu hamil dengan diabetes pada tahun 2018 -2021 yang dikumpulkan dari beberapa rumah sakit di Kota Depok, dengan metode penguumpulan data secara total sampling. Selanjutnya data dianalisis secara univariat (analisis statistic deskriptif) dan bivariat (chi square, fisher exact test, dan t-test). Hasil: Tidak didapatkan hubungan yang signifikan antara persalinan pada ibu diabetes dengan usía (p=0,71), status gizi (p underweight = 0,333, p overweight = 0,576, p obesitas I = 1,000, p obesitas II = 1,000), riwayat paritas (p 0 kali = 0,364, p 2 kali = 1,000, p 3 kali = 1,000, p >3 kali = 0,308), riwayat abortus (p=0,434), riwayat penyakit lain (p=464), riwayat kontrasepsi (p=0,296), BBLB (p=0,528), dan panjang bayi lahir (p=0,929). Tidak diapatkan hubungan yang signifikan antara kondisi pandemi dengan tingkat ekonomi (0,756), tingkat pendidikan (p=1,000), pekerjaan (p=-0,107), BBLB (p=0,432), dan panjang lahir bayi (p=0,381). Adapun ditemukan hubungan yang signifikan antara riwayat sesar sebelumnya dengan jenis persalinan pada ibu diabetes, dimana ibu diabetes yang memiliki riwayat sesar sebelumnya memiliki risiko 1,5 kali lebih tinggi melakukan persalinan sesar disbanding yang tidak memiliki riwayat sesar (95% CI 1,149-1,959, P=0,008). Tidak terdapat hubungan yang signifikan antara kondisi pandemi dengan jenis persalinan pada ibu hamil dengan diabetes (p=0,716). Kesimpulan: Kondisi pandemi COVID-19 yang terjadi pada tahun 2020 di Indonesia, tidak memiliki hubungan yang signifikan terhadap jenis persalinan ibu hamil yang memiliki riwayat diabetes.
Kata kunci: Diabetes, Pandemi COVID-19, Ibu, Persalinan, Sesar



Introduction: Pregnant women with diabetes have a higher chance of having a cesarean delivery than normal deliveries and a higher chance of having a macrosomia baby. As for the delivery method of pregnancy with diabetes, cesarean section and fetal macrosomia, has a bad impact on the health and safety of the mother and the baby. The COVID-19 pandemic that occurred in Indonesia since 2020, affects several aspects of life, one of which is the health aspect. One of the diseases that increases in incidence and severity in pandemics is diabetes. This is certainly an important thing that needs to be considered, especially by mothers, so it will not interfere with the health of the mother and also the baby. Method: The study was conducted with an analytic cross-sectional design, with secondary data in the form of medical records of pregnant women with diabetes in 2018 - 2021 which were collected from several hospitals in Kota Depok, with total sampling data collection method. Furthermore, the data were analyzed by univariate (descriptive statistical analysis) and bivariate (chi square, fisher exact test, and t-test) analysis. Result: There were no significant relationship between type of delivery in diabetes maternal with age (p=0.71), nutritional status (p underweight = 0.333, p overweight = 0.576, p obesity I = 1,000, p obesity II = 1,000), history of parity (p 0 times = 0.364, p 2 times = 1,000, p 3 times = 1,000, p >3 times = 0.308), history of abortion (p=0.434), history of other diseases (p=464), history of contraception (p=0.296 ), LBW (p=0,528), and newborn’s body length (p=0,929). There was no significant relationship between the pandemic condition and the economic level (0.756), education level (p=1,000), occupation (p=-0.107), LBW (p=0.432), and newborn’s body length (p=0.381). There was found a significant relationship between a history of previous cesarean delivery and the type of delivery in maternal with diabetes, where diabetic mothers who had a previous cesarean delivery had a 1.5 times higher risk of having a cesarean delivery compared to those who did not have a history of cesarean delivery (95% CI 1.149-1.959, P =0.008). There was no significant relationship between pandemic conditions and the type of delivery in pregnant women with diabetes (p=0.716) Conclusion: The condition of the COVID-19 pandemic that occurred in 2020 in Indonesia did not have a significant relationship with the type of delivery of pregnant women with a history of diabetes.
Keywords: Diabetes, COVID-19 Pandemic, Maternal, Delivery